Plans have been put forward to cut hospital services in two-thirds of England

nicko31 · Feb 21, 2017

Problem is we want Swedish style public services with US levels of taxation, it just doesn't work.

With Brexit costs, obesity and an aging population it really is the perfect storm for the NHS. Time for some serious reform

beorhthelm · Feb 21, 2017

BBassic said:
https://www.kingsfund.org.uk/publications/delivering-sustainability-and-transformation-plans

That took all of one Google search, two clicks, a copy and paste and the time to write this post. One minute, tops.

wonder how many people will not bother with the summary there, and only read the BBC peice, and from that make all sorts of misguided assumptions about this? the other week a thread here had a theme that we need reform how we fund and how we deliver healthcare, this report is looking at that. move healthcare away from expensive Hospitals to facilities in the community. as long as those facilities are there, who thinks that's a bad idea?

Adders1 · Feb 21, 2017

The NHS is being dismantled slowly but surely. Its such a complex issue, i don't think that NSC will ever be able to solve it. If it is to stay the same, with population growth, there needs to be more doctors and nurses, that is a given. What i don't understand is why becoming a doctor is so hard and expensive.

LamieRobertson · Feb 21, 2017

bashlsdir said:
Government can't put any more money than it is now, solution we all personally pay a bit more.

Well thats twice you've mentioned paying more...so how do they go about that then...how much more...where would that money go...would it be ring fenced etc etc

BBassic · Feb 21, 2017

bashlsdir said:
Government can't put any more money than it is now, solution we all personally pay a bit more.

What about those of us who can't afford to pay any more?

"Ah well, they're only poor, that leg will probably set itself eventually"

jackanada · Feb 21, 2017

GOM said:
links to these facts please

I happily admit this doesn't show us ranking as low as I recalled and it's hard to track down everything I've read on the subject, but here's some perspective on our health spending.
https://www.kingsfund.org.uk/blog/2016/01/how-does-nhs-spending-compare-health-spending-internationally

El Presidente · Feb 21, 2017

BBassic said:
What about those of us who can't afford to pay any more?

"Ah well, they're only poor, that leg will probably set itself eventually"

I think Jeremy Hunt has the solution

Publius Ovidius · Feb 21, 2017

personally I think it will come to a situation where the NHS is there as a safety net and one that specialises in trauma and serious health cases. Emergency work etc.

People with aging issues like hip replacements/cataracts etc and the like will be required to do this via a public/private funding, where you will be asked to pay a proportion of the costs ( probably means tested) and the government top up. The private sector hospitals will be required to take up the slack, a bit like they do now with some NHS operations.

the real shame is we all saw this coming. I attended a course in 2000 getting me to buy into a decent pension plan as the guys there explained that the government would not be able to afford state pensions in the future ( ie now) due to the aging population and at the time raging inflation. We were also told that again due to aging population and the development of more sophisticated and expensive treatments the NHS wouldnt be able to cope...that was a hell of a prediction at the time.

Social health care is the scandal of this generation. The ideas back in the day of getting people out of hospital and back home with a full care plan and fully staffed social services and care community was a utopian view, which actually, be you a socialist or not , is really how society should work, however since the financial crash and nervousness around the "deficit", budgets have been slashed and social care is at the fore front of that. I have a colleague whose wife is a community social care worker and three years ago there was 26 in her department, now there are 6 and the amount of people they have had to deal with in case load has trebled in that time ( even with the same amount of staff that would have been impossible to cover).

She thinks society needs to come up with a radical way of looking at social care with more people taking care of elderly family members rather than letting the state or private companies take the burden with assistance from the existing social care system. I suppose this is a laudable ideal, but our society does not see this as many countries around the world who see it as a duty of teh children to look after the parents when they need it most.

Trouble is this becomes a "obama care" type polarising issue. Politicians neeed to come to a consensus how we want society to be looked after in the future and put political dogma aside. Like that is ever going to happen!

drew · Feb 21, 2017

bashlsdir said:
Government can't put any more money than it is now, solution we all personally pay a bit more.

Why can't the Government put more in? Your comment makes no sense!

drew · Feb 21, 2017

daveybgtt said:
Less managers, more doctors and nurses would be a good start, Then ditch foreign aid and build more hospitals.

DaveyB for PM!

Out of interest, what managers do you think the NHS should ditch and if they did, who do you think should take on the work that they currently do.

Deleted member 22389 · Feb 21, 2017

LamieRobertson said:
Well thats twice you've mentioned paying more...so how do they go about that then...how much more...where would that money go...would it be ring fenced etc etc

Ring fenced fiver a month for everyone. Think that's a fair price.

HantsSeagull · Feb 21, 2017

bashlsdir said:
Yes we all pay a bit more money to use it. Happy to pay more.

yeah i get that - as would i in theory. But do you never worry that we are pouring more and more money in and yet services seem to get worse and worse, whilst you have hoardes of managers and administrators earning significant sums whilst services and front line employees suffer.

I fear it is a bottomless pit

GT49er · Feb 21, 2017

drew said:
Out of interest, what managers do you think the NHS should ditch and if they did, who do you think should take on the work that they currently do.

Just take out a random ten percent of managers and admin. for starters, mainly among the top earners (sorry - I mean make redundant, not 'take out'!) And I'm talking from first hand experience - I used to work there!

The Clamp · Feb 21, 2017

pastafarian said:
with so much fake news about would it kill you to provide the link to the info you have taken the time to copy and paste.

****

LamieRobertson · Feb 21, 2017

bashlsdir said:
Ring fenced fiver a month for everyone. Think that's a fair price.

And how much would that raise? How would it be spent? Would everyone pay whether in work or unemployed or retired

wellquickwoody · Feb 21, 2017

bashlsdir said:
Ring fenced fiver a month for everyone. Think that's a fair price.

This is the bit that many people do not understand. With the increasing age of our population, the increasing cost and complexity of treatments, the expectations of some people for cosmetic surgery and our growing population the actual price of funding the NHS has risen enormously. To fund it properly would probably require more like a tenner per week from everyone, that is £40 per month. I'm all for it, who else is in?

WATFORD zero · Feb 21, 2017

LamieRobertson said:
And how much would that raise? How would it be spent? Would everyone pay whether in work or unemployed or retired

It's almost as if he is telling you what the solution is without any giving any thought or consideration to what the problem is. If only there were a political party which would adopt this approach

dingodan · Feb 21, 2017

HantsSeagull said:
yeah i get that - as would i in theory. But do you never worry that we are pouring more and more money in and yet services seem to get worse and worse, whilst you have hoardes of managers and administrators earning significant sums whilst services and front line employees suffer.

I fear it is a bottomless pit

We can say we will pay more today, but we will also have to pay more tomorrow, and the day after.

People don't like to hear it but the fact is that we will have these problems until we come to terms with the fact that governments are not capable of delivering products or services, they never have been and they never will be, and it's not meant to be their role for that very reason.

The fact is, as with any product or service, if you want the best distribution at the highest quality and the lowest cost, you have to operate under market conditions. It's not a popular idea, but until we are willing to consider it we will continue to have these problems, and eventually, if we take this system to it's inevitable conclusion, nobody is going to get any decent standard of medical care at all.

GT49er · Feb 21, 2017

dingodan said:
We can say we will pay more today, but we will also have to pay more tomorrow, and the day after.

People don't like to hear it but the fact is that we will have these problems until we come to terms with the fact that governments are not capable of delivering products or services, they never have been and they never will be, and it's not meant to be their role for that very reason.

The fact is, as with any product or service, if you want the best distribution at the highest quality and the lowest cost, you have to operate under market conditions. It's not a popular idea, but until we are willing to consider it we will continue to have these problems, and eventually, if we take this system to it's inevitable conclusion, nobody is going to get any decent standard of medical care at all.

Yeh, privatise everything - that always works well, doesn't it? I mean, where would our rail services be if we hadn't brought in Southern to sort it out. And I'm sure the government will step in and sort it out when the anaesthetists go on strike in protest against cost-cutting surgeon-only operations, with the surgeons applying the anaesthetic too.

dingodan · Feb 21, 2017

GT49er said:
Yeh, privatise everything - that always works well, doesn't it? I mean, where would our rail services be if we hadn't brought in Southern to sort it out. And I'm sure the government will step in and sort it out when the anaesthetists go on strike in protest against cost-cutting surgeon-only operations, with the surgeons applying the anaesthetic too.

Southern rail are in the special position of facing absolutely no competition whatsoever. As is the case with our current medical system.

The primary force which drives up quality and down prices is competition. In fact it's the only thing that does.

Note also the following:

THE year-long Southern rail dispute hitting hundreds of thousands of commuters was triggered by a Government contract, it has emerged...

...A Southern spokesman added: “We have a franchise commitment to expand the role of driveronly operation (DOO) trains to more of our routes in order to be able to transfer conductors to the role of on-board supervisors.

“That is written into our contract, specified by the Department for Transport.”

The Government’s tender document says the operator should “implement DOO on all services that operate on the Core Thameslink Route throughout the Franchise Term”.

http://www.express.co.uk/news/uk/74...hris-grayling-govia-thameslink-railway-unions

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